Get to the Chopper

The Role of Helicopters in Rescue.
Randy Manuel

In movies and TV shows choppers are always available and nearby, day or night, regardless of the weather; apparently anyone can “call one up” in a moment’s notice. They can operate anywhere, with only inches of clearance on all sides, in hurricane force winds in the dead of night. They fly upside-down, while ninjas riding grizzly bears are shooting rocket-sharks at the hero who, hanging one-handed from the skid, steely eyed, grimacing in pain from a “flesh wound,” abs glistening in the sunlight … well, you get my point.

Helicopters are amazing machines that are an integral part of many rescues. Their primary function is to reduce the time it takes to deliver a patient to definitive care. The hour-and-a-half drive from our offices in Wesser, NC to Asheville is about a 20-minute flight. That hour saved can make all the difference for a critically ill or injured patient. The use of helicopters is responsible for saving thousands of lives, but they have some very real limitations that are important to understand. Here in Western North Carolina, there are two types of helicopters we might encounter: air ambulances and rescue helicopters.

First, let’s talk about the air ambulances. These are small, well-equipped, and staffed by highly trained medical personnel. The paramedics and nurses on these medical teams take care of us in our most dire circumstances. This type of helicopter can be faster and more efficient than a regular ground ambulance, so they are often used to transport critically ill or injured patients. They can only land in large, flat, clear spaces, which in this area, means parking lots and intersections. With an air ambulance, someone must drag, carry, or assist the patient to a road or trailhead to meet a regular ground ambulance. Next, the ambulance crew must drive the patient to a safe landing zone for transfer to the air ambulance. Finally, the air ambulance can transport the patient to a hospital. Although this type of helicopter can shorten transport times considerably, their major limitation is that they cannot access patients directly.

Second, we have the Blackhawk-type rescue helicopters. These larger, more powerful helicopters are designed to fly further, faster, and have additional rescue capabilities. The decision to dispatch a rescue helicopter can only be made by the county’s EMS director. Unlike an air ambulance, these helicopters do not need to land and their medical teams can rappel down to the patient and begin treatment before hoisting them out. They can aid in the search for patients and do not need the assistance of ground ambulances to access and transport patients. The major limitation with these is the time involved. The closest Blackhawk to the gorge is based out of Charlotte, NC, 193 miles away. It can take up to two hours for them to be airborne following a dispatch, and then around 45 minutes to get to the Nantahala Forest. 

Helicopters are amazing and the people who crew them are among the best emergency medical providers in the world. However, the availability of helicopters is not a replacement for having the tools and training necessary to respond to an emergency in the backcountry. They cannot fly through storms and they cannot land wherever they want. It takes time for them to prep, take off, and travel to their patient.  

The bottom line is that helicopters – and the people that crew them – are extraordinary, but it is not, nor will it ever be, “as seen on TV”.